management of information and communicationmyresource.phoenix.edu/secure/resource/hcis275cr1/... ·...

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At the end of this chapter, the student should be able to:

8 chapter eight

Management of Information and Communication

Default values

Flags

Internet

Intranet

Live

Master file

Optical character recognition (OCR)

Resolution

Scanner

Templates

Key Terms

8.4 Create custom screens within PrimeSUITE.

8.5 Develop a task list within PrimeSUITE.

8.6 Set up system flags within PrimeSUITE.

8.1 Use software as an internal communication tool.

8.2 Differentiate the steps used to import documents using scanning technology.

8.3 Build master files and templates using PrimeSUITE.

Learning Outcomes

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160 http://connect.mcgraw-hill.com

8.1 Internal Communications

The Internet is a series of networks that allows instant access to

information from around the world. Internet sites may be private,

requiring a user ID and password to gain access, or they may be

public sites that are viewable by anyone. Within an organization,

however, the intranet exists. An intranet is a secure environment or

private internal network that is available only to a select group, e.g.,

the staff, within an organization. Examples of what might be shared

on an intranet site include:

Facility’s mission and value

statements

Directory of staff and

care providers

Compliance officer’s name

and contact information

Policies and procedures FAQs Forms, publications,

newsletters

Organization charts Office meeting

minutes

Calendar of events

Link to the IT department Calendar of upcoming

events

Internal webmail link

The intranet is a one-stop-shop of all the information needed to

stay informed about a company and a way to send and receive mes-

sages from colleagues. Of course, someone (usually a webmaster) has

to keep the information up-to-date; otherwise, the outdated informa-

tion is not information at all, and there is no benefit to having an

intranet. When staff starts noticing that the site is not being kept cur-

rent, they will stop accessing it and information will no longer be

The Big Picture

What You Need to Know and Why You Need to Know It So far in this text, we have mainly looked at information being collected. In this chapter we will

look at communicating that information. The information collected in a healthcare environ-

ment is shared with external sources such as public health agencies, Medicare, insurance com-

panies, and professional organizations. The information included may be in the form of a

summary of a patient’s chart, a report that answers a question, such as the local public health

office asking how many cases of flu-related illnesses were seen during a given time period, or

a piece of correspondence from one care provider to another. Additionally, the communication

may be internal—within the facility. With PM and EHR software, communicating internally

through use of an internal e-mail system is efficient. Information is key to almost everything we

do, personally and professionally, so having the information we need at our fingertips and

communicating that information accurately and in a timely fashion are key a to a well-run

organization. Taking it a step further, patients who receive timely, accurate information and

who experience good communication within the practice will have more confidence in the

practice as a whole.

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161

shared. If your current employer does have an intranet, take some

time to really navigate it—look for the information stated above, and

see if you can find other useful information there.

The use of internal messaging improves communication within

an office. It is particularly helpful in avoiding the “no one ever told

me” syndrome. When internal e-mail is used to communicate work-

related information, and is not cluttered with personal communica-

tions, it is even more valuable. Many organizations have policies

regarding work e-mail for personal use, and though they may not

mandate that it cannot be used as a personal means of communica-

tion, such use is most likely frowned upon and may lead to more

stringent policies. Some offices use a priority rating on their work-

related e-mails. This is particularly helpful to the care providers in

sifting out what needs to be done immediately versus what can wait

for a later time. High-priority messages would include patient care

matters, medium priority would include changes in meeting dates

or time-sensitive information, and low priority might be information

such as lunch is ready in the lounge or FYI messages. When estab-

lishing rules for the priority system, everyone should at least be clear

on what is and is not considered high priority.

8.1

Send an Electronic Message Using PrimeSUITE Messaging

In this exercise we will look at carrying out an internal communication using

PrimeSUITE. In the exercise that follows, Dr. Ingram is to attend an EMR

meeting, but the date and time have been changed. In this instance, the

message would only be sent to Dr. Ingram; if the message were for all of the

care providers, then it would be sent using a group rather than typing in one

name.

This function is accessible from the desktop screen.

Follow these steps to complete the exercise on your own once you

have watched the demonstration and tried the steps with helpful prompts in

practice mode. Use the information provided in the scenario above to com-

plete the information.

1. Click No unread messages.

2. Click Compose Message .

3. The To: field is filled out with jingram. Press the tab key to confirm

your entry.

4. Press Tab again to advance to the next field.

5. The Subject: field is filled out with EMR Meeting. Press the tab key

to confirm your entry.

6. Click Priority:.

7. Click Medium.

8. The Salutation (Dr. Ingram) is added. Press the tab key to confirm

your entry.

EXERCISEGo to http://connect.mcgraw-hill.com to complete this exercise.

EHR PMHIM

You learned earlier in this text that the terms electronic medical record (EMR) and elec-tronic health record (EHR) are often used interchangeably. At Greensburg Medical Center, EMR is the preferred terminology.

fyifor your information

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Communication involves many forms other than e-mail messages.

Reports, test results, or verifications of insurance coverage, just to

name a few, are communicated many times throughout the day.

These reports may be sent to the practice in digital or hard–copy

format but in the end must be merged into the appropriate patient’s

record.

For example, Dr. Ingram sent Max Shaw to Memorial Hospital

for a chest x-ray. The x-ray is completed and the report of the radiolo-

gist’s findings is sent electronically to Greensburg Medical Center. It

then needs to be merged (attached) to the patient’s chart—the flow of

this is depicted in Figure 8.1 .

Not all documents can be sent electronically, however. Case in

point—let’s say a patient, David Malone, had his chest x-ray at

Duffields Hospital, which does not have electronic capability yet.

Instead, the report of the x-ray findings is in hard–copy form only.

It can be faxed, mailed, or picked up from the hospital by a staff

member. Since the goal of Greensburg Medical Center is a paper-

less office with a unit record for all patients, a hard–copy image

would need to be manually scanned into the EHR once it arrives at

the office (Figure 8.2).

8.2 Importing Documents to the EHR

Results areelectronicallytransmitted toGreensburg

Medical Center

Report is stored inPrimeSUITE’S

EHR

Report is mergedwith record of

Max Shaw

Patient hasx-ray at

MemorialHospital

Figure 8.1 Flow of report from hospital to merging with appropriate record in PrimeSUITE

Radiologistinterprets

x-ray

X-ray report istranscribed

Report is mergedwith

record

Report isreceivedby GMC

Report isscanned intoPrimeSUITE

Report isfaxed to

GMC

Patient hasx-ray

at DuffieldsHospital

Figure 8.2 Flow of faxed report from hospital to PrimeSUITE

9. The message body (Just as a reminder, the EMR meeting this week

has been moved to Thursday at 3:30 p.m.) is filled out. Press the tab

key to confirm your entry.

10. Click Send message.

11. Click the “x” to Close.

❑ You have completed Exercise 8.1 ✓

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163

When a hard–copy document needs to be scanned, the health-

care professional simply feeds the document through the scanner (or

lays the document flat on a screen) (see Figure 8.3 ), follows the

prompts that appear on the computer screen, and finally merges

(attaches) the document with the proper patient’s record within

PrimeSUITE. The process of scanning is much like the process of

making a photocopy. Just as a hard-copy document can be misfiled,

so can a scanned image. Before a scanned

image is attached to a patient’s health

record, the healthcare professional verifies

that the correct patient and the correct visit

are selected. Also, the type of document

(correspondence, authorization, history or

physical exam, for example) may be bar-

coded so that the document is easily retriev-

able electronically.

Scanners digitize documents into a for-

mat that is readable by the computer. The

scanning of documents utilizes optical character recognition technology to con-

vert the document into a format that is com-

puter readable. There are other scanning

functions that you may be aware of and

may not even realize it—in a grocery store,

the cashier passes the bar code from a can

of green beans across a small light source;

he has just scanned the bar code so that the computer reads it as a

15.5-ounce can of green beans with a price of $1.25. In that case, the

optical reader has read a bar code rather than words. This process

not only results in a price for the item, it is also part of an inventory

control system—the person(s) responsible for re-order now know

that there is one less can of beans on the shelf!

Figure 8.3 Scanner used to import a document

Scan an Insurance Card into a Patient’s Record

In the scenario that follows, Jessie Hamilton’s insurance card is scanned

using a desktop scanner at the time he checks in. Once it is scanned, the

document is merged (attached) with Jessie’s chart in PrimeSUITE. If your

doctor’s office is automated, the next time you arrive for an appointment

and present your insurance card, watch this process. In all, it only takes a

minute. In the exercise that follows, you are asked to enter the resolution , that is, the quality of the image as it will appear in the record. Obviously, in a

legal record, the highest resolution would be selected.





8.2 ExerciseGo to http://connect.mcgraw-hill.com to complete this exercise.

HIM EHR PM

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8.3 Master Files and Templates

Care providers and all healthcare professionals are extremely busy.

Their first concern is the patient, not documentation. So, to make

documenting easier and faster, master files (datasets that provide

structure and are the building blocks for parts of the chart notes) and

templates (preformatted documents built into the PM and EHR sys-

tems) are used. If you think back to the exercises in Chapter 4, you

saw many master files. Figure 8.4 is an example of a master file for

selecting conditions in a patient’s past medical history.

At Greensburg Medical Center, before the EHR went live (in use

in real time), members of the staff built these master files with input

from care providers. Master files list common conditions and diag-

noses that patients at Greensburg Medical Center have had. Diagno-

ses can be added to an individual’s record, or to the master file itself.

Other master files in PrimeSUITE include PE, ROS, orders, diagnosis

favorites, and HPI.

Figure 8.4 Past medical history master file

1. Click Document Import.

2. The * Last Name field is filled out. Press the tab key to confirm your

entry.

3. Click Search.

4. Click Select.

5. Click Quick Scan using existing scanner settings.

6. Press Click to move all pages to Selected list (double arrows).

7. Click Select Document Type:.

8. Clicking the entry Insurance Card selects it.

9. Click Save Resolution.

10. Click Quality (High).

11. Click Save.

❑ You have completed Exercise 8.2✓

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CHAPTER 8 MANAGEMENT OF INFORMATION AND COMMUNICATION 165

Building templates within the system is an administrative task

that is done prior to going live, but they can be added to as neces-

sary. Templates are preformatted documents that allow screen-

shots to be built, letters to be written, and progress notes to appear

out of individual selections from master files. Care providers may

prefer their documentation to look a certain way, so a practice that

has five care providers may have five templates for written prog-

ress notes.

8.4 Customization

Care providers, registration staff, medical assistants, nurses, thera-

pists, billers, and coders all use the information in the PM and EHR

software. But not all of the users “see” things the same way. The way

information and subsets of information display in relation to one

another on a computer screen is often most effective when the user is

Build a Master File in PrimeSUITE

To build a master file in PrimeSUITE, the Desktop will be accessed and then

Review of Systems Admin will be selected from the Chart menu. In the exer-

cise that follows, we will build the master file for Review of Systems (ROS).

The end product will be indicative of what this care provider wants as the

default values ( the value that automatically appears in a field) on the ROS

screen and appears each time he sees a patient. For instance, the care pro-

vider wants the default value for weight loss to be a negative response; in

other words, if a patient is asked if she has experienced unexplained weight

loss, most of the time the answer will be no; therefore, this response will

show as (- ) weight loss on the ROS screen.

Setting up these default values is done from the System Set-Up module

on the Chart menu.



practice mode.

1. Click Review of Systems Admin.

2. Click Constitutional.

3. Clicking the entry fatigue selects it.

4. Clicking the entry weight loss selects it.

5. Click Genitourinary.

6. Click urgency.

7. Click frequency.

8. Click dysuria.

9. Click Save.

❑ You have completed Exercise 8.3

Go to http://connect.mcgraw-hill.com to complete this exercise.

PMEHRHIM 8.3 EXERCISE

✓

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satisfied with how the information appears. Much PM and EHR soft-

ware includes flexibility to allow customization of screen configura-

tions, and PrimeSUITE is no exception. Care providers and healthcare

professionals in general will be more accepting of an EHR if they

know they have some say in the appearance of the information.

Customize a Facesheet Screen

We will now look at a couple of exercises where customization is possible.

The first task is to customize a Facesheet screen. In this scenario, the

healthcare professional is going to customize a Facesheet. He starts by

entering the User Settings Admin within the System Setup module that is in

the Chart menu. Watch as he chooses the elements that will show on the

Facesheet, and then how he changes the order in which they appear.

Follow these steps to complete the exercise on your own once you have

watched the demonstration and tried the steps with helpful prompts in practice mode.

1. Click User Settings Admin.

2. Clicking the Facesheet & History tab selects it.

3. Click History Sections.

4. Click Facesheet Sections.

5. Click Save User Preferences.

6. Click Patient Charts.

7. Click Customize Facesheet.

8. Click Reason For Visit.

9. Click Allergy List.

10. Click Clinical Alerts.

11. Click Confidential.

12. Click Family Medical History.

13. Click Flowsheets.

14. Click Medication List.

15. Click Orders Tracking History.

16. Click Past Medical History.

17. Click Past Surgical History.

18. Click Problem List.

19. Click Social History.

20. Click Task List.

21. Click Visit History.

22. Click Vital Signs.

23. Click anywhere to the left of the Customize Facesheet menu

to close it.

24. Drag Medication List.

25. Drop on Confidential.

In addition to the Facesheet, the desktop can also be customized to

meet the individual user’s preferences.


8.4 EXERCISE Go to http://connect.mcgraw-hill.com to complete this exercise.

PM HIMEHR

✓

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Customize a Clinical Desktop

Watch as this user sets up the Desktop (the first screen that appears when

a user logs on) to meet her needs and preferences.



practice mode.

1. Click Customize Desktop.

2. Click Patient List.

3. Click Use Clinician Desktop.

4. Click Show Orders Tracking.

5. Click Show Unsigned Documents List.

6. Click Show Task List.

7. Click Section First.

8. Clicking the down-arrow opens a drop-down list.

9. Click Patient List.

10. Click Save.


8.5 EXERCISEGo to http://connect.mcgraw-hill.com to complete this exercise.

PMHIM EHR

✓

8.5 Using Software to Organize Your Work—Task Lists

With all the requirements we deal with in healthcare, having help

with organizational skills is certainly an advantage! In PrimeSUITE,

there is a functionality called a Task List or Tasks, where a care pro-

vider or other healthcare professional assigns tasks to another staff

member or to an entire group. For instance, Dianna Pike, a care pro-

vider, wants a particular report to be run by the office administrator,

Jon Viria. The request is simply put into Jon’s task list so that he is

aware that he has a task that needs to be completed. Or, if it is a task

to be completed by an entire group, for instance, the health informa-

tion department staff, the task—completion of a computerized in-

service—can be assigned to the group rather than to each individual,

saving the office administrator much time and ensuring that every-

one gets the same message!

Some examples of tasks include:

• Renewing magazine subscriptions for the reception area

• Registering for an upcoming seminar

• Calling a patient regarding the need for a follow-up laboratory

test

• Making reservations for the office holiday party

As you can see, the tasks may not be clinical in nature; they can

be anything that needs to be done by an individual or individuals in

the practice.

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Create a Task for the Receptionist

In the scenario that follows, a task is set up for Charlotte Baker to schedule

a training session on ePrescribing. The message is “Charlotte, will you

please contact Greenway and arrange a training session covering ePre-

scribe? I would like to have this done between April 15th and May 30th.

Thanks!” (without the quotes).

This function also allows the user to select the priority of the task—

high, medium, or low. Practice policy may dictate what circumstances

dictate each, and whether prioritization is used at all.

Follow these steps to complete the exercise on your own once you have

watched the demonstration and tried the steps with helpful prompts in prac-

tice mode. Use the information provided in the scenario above to complete

the information.

1. Click Tasks.

2. Click Add New Task.

3. Click Type:.

4. Clicking the entry General Task selects it.

5. Click Send To:.

6. Click scroll button.

7. Click Baker, Charlotte (cbaker).

8. Click OK.

9. Click Subject:.

10. The Subject: field is filled out with eRX training. Press the tab key to

confirm your entry.

11. Click Due Date

12. Click 15.

13. Click Status.

14. Clicking the entry New selects it.

15. Click Add Comment:.

16. The Comment: field is filled out. Press the tab key to confirm your entry.

17. Click OK.

18. Click Save & Return.

19. Click Close.


Go to http://connect.mcgraw-hill.com to complete this exercise.

PM HIMEHR8.6 EXERCISE

8.6 Using Software as a Reminder

If you work in healthcare you have a lot to remember, as you have

already seen. It would be next to impossible to remember every situ-

ation about every patient. Using the functionality of PM or EHR

software, including PrimeSUITE, makes keeping on top of every-

thing easier, though, by including alerts or reminders in a patient’s

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chart, through a series of flag alerts (reminders), or icons, each of

which has a particular meaning.

Flags can be added in the system and can be used for any and all

patients.

Examples of common flags include:

• Frequently cancels appointments

• Phone number on file is no longer in service

• Confidentiality messages (such as do not leave message on

home phone)

• Co-pay required (and can include amount)

• Patient is noncompliant

• Account in collections

• Do not charge late fee

• Payment plan set up

• Allergic to penicillin (can have several different medications)

• Environmental allergy to _____

• Sensitive information contained in chart

• Clinical alerts

– Bone density scan due

– Diabetic patient

– Requires patient education

– Pap smear due

A flag can be set up in the system for just about anything the

office sees a need for. A word of caution though; do not set up so

many flags that it is difficult to remember their meaning, or so that

the alert becomes the rule rather than the exception and therefore is

ignored!

169

8.7

Assign a Flag to a Patient’s Chart

In our final exercise, you will set up a system flag for a patient. In this case,

Jessie Hamilton is allergic to bee stings, so the healthcare professional will

add that flag to Jessie’s chart.





1. Click Search for Patient.

2. The * Last Name field is filled out. Press the tab key to confirm your

entry.

3. Click Search.

4. Click Select.

EXERCISEGo to http://connect.mcgraw-hill.com to complete this exercise.

PMEHRHIM

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5. Click View/Edit Patient Flags.

6. Click Allergic to Bee Stings.

7. Click Save.

So as you can see, computerization of the practice management and

health record functions has many other benefits to care providers and staff

than just maintenance of the information they collect. The use of software

streamlines the processes and increases efficiency as well.


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LEARNING OUTCOME CONCEPTS FOR REVIEW

8.1 Use software as an

internal communication tool.

pp. 160–162

– Difference between Internet and intranet

– Examples of information commonly shared on an intranet

– Send a message using PrimeSUITE

8.2 Differentiate the steps

used to import documents

using scanning technology.

pp. 162–164

– Reports within a chart are a type of communication

– Documents may be imported from within PrimeSUITE or from an

external source

– Scanning a document involves a process of feeding (or laying flat)

the document in the scanner, then attaching the document to the

appropriate patient’s chart

– Scanning digitizes documentation into readable format

– Optical character recognition (OCR) allows scanned images to be

edited

– Scan an insurance card and import it into the record of Jessie

Hamilton

8.3 Build master files and

templates using PrimeSUITE.

pp. 164–165

– A master file is a listing of possible choices, e.g., a list of allergies,

list of conditions, list of surgeries

– Templates allow for building an end–product such as a progress

note, a piece of correspondence, or a screen view

– Build a master file for an ROS

8.4 Create custom screens

within PrimeSUITE.

pp. 165–167

– Allow flexibility and personalization for individual users

– Design a Facesheet view for a user

8.5 Develop a task list

within PrimeSUITE.

pp. 167–168

– Tasks are reminders that a job has been assigned

– Can be made by any user

– Can be a task set for a single user or a group

– Assign a task to a user in PrimeSUITE

8.6 Set up system flags

within PrimeSUITE.

pp. 168–170

– Flags are alerts or reminders

– Use them sparingly; otherwise, they no longer point out the excep-

tion to the rule, but rather become the rule

– Set up a flag on a patient’s record in PrimeSUITE

chapter 8 summary

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Enhance your learning by completing these exercises and more at http://connect.mcgraw-hill.com!

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Enhance your learning by completing these exercises and more at http://connect.mcgraw-hill.com!

p

MULTIPLE–CHOICE QUESTIONS Select the letter that best completes the statement or answers the question:

1. [LO 8.1] The Internet is ________ and an intranet is ________ .

a. public; private

b. private; public

c. private; private

d. public; public

2. [LO 8.2] A hard–copy document is attached to a patient’s electronic chart by:

a. copying.

b. e–mailing.

c. scanning.

d. shredding.

3. [LO 8.3] Using templates makes it easier for care providers to focus on their first priority, which is:

a. documentation.

b. patient care.

c. office staff.

d. training.

a. secure internal environment available only to a select group

b. device that digitizes documents into a format readable by computers

c. an alert or reminder that appears in a patient’s chart

d. dataset that provides structure and is the building block for parts of the chart notes

e. software that allows a saved document to be edited

f. using something in real time

g. area where work can be assigned to staff members and progress can be monitored

h. preformatted documents built into an EHR or PM system

1. [LO 8.6] flag

2. [LO 8.5] task list

3. [LO 8.3] master file

4. [LO 8.3] templates

5. [LO 8.1] intranet

6. [LO 8.3] live

7. [LO 8.2] scanner

8. [LO 8.2] optical character recog-nition (OCR)

MATCHING QUESTIONS Match the terms on the left with the definitions on the right.

chapter review


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4. [LO 8.4] PrimeSUITE allows each user to ________ certain features to their liking.

a. access

b. customize

c. delete

d. revise

5. [LO 8.1] A facility needs to make sure that the information on their intranet does not become:

a. outdated.

b. overused.

c. private.

d. secure.

6. [LO 8.6] It is ________ to have too many flags set up in PrimeSUITE.

a. impossible

b. possible

c. necessary

d. required

7. [LO 8.3] The Review of Systems menu choices in PrimeSUITE is an example of a/an:

a. index.

b. master file.

c. real–time menu.

d. template.

8. [LO 8.5] A healthcare professional may assign work to another user with Prime-SUITE’s ________ functionality.

a. assignment

b. groups

c. tasks

d. workload

9. [LO 8.6] Which of the following is another term for “flag”?

a. Alert

b. Avatar

c. Decal

d. Symbol

10. [LO 8.4] Which of the following PrimeSUITE functions may be customized by a user?

a. Access rights

b. Insurance policies

c. Patient information

d. Screen layout

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SHORT ANSWER QUESTIONS: 1. [LO 8.1] List four things that might be found on an organization’s intranet.

2. [LO 8.3] Could one medical office have more than one template for a referral letter? Explain.

3. [LO 8.2] Explain the process of scanning.

4. [LO 8.1] What will happen if an office’s intranet is not kept current?

5. [LO 8.3] List four advantages of using master files and templates in a healthcare office.

6. [LO 8.6] List at least eight common flags used in PrimeSUITE.

7. [LO 8.6] Why might it be good to have a “Sensitive information contained in chart” alert pop-up when users access specific patient charts?

8. [LO 8.5] Explain how using the Task List function in PrimeSUITE helps to organize work.

9. [LO 8.4] Why might healthcare professionals be more accepting of an EHR if they are able to customize it in some way?

APPLYING YOUR KNOWLEDGE 1. [LO 8.4] How might a care provider “see” the information display in PrimeSUITE in

the same way a patient registration staff member would?

2. [LOs 8.1, 8.2, 8.6] As office manager, what are some ways for you to ensure that staff members remember to attach hard–copy documents to the patient charts they are working on?

3. [LO 8.3] Discuss two advantages and any potential disadvantages to using templates for communication documents.

4. [LOs 8.5, 8.6] You are the office manager for a small practice. Since your office recently implemented an EHR system, you would like to have a staff training session to set forth guidelines and best practices for using system flags. Explain how you would use PrimeSUITE to assist you in your task, and come up with four talking points about proper use of flags and alerts.

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